Tuberculosis is an infectious disease generally caused by Mycobacterium tuberculosis that exists as a latent and an active condition. Latent tuberculosis occurs when tuberculosis bacteria infect the body but remain in an inactive state. According to the World Health Organization Global Tuberculosis Report for 2018 (https://www.who.int/tb/publications/global_report/en/), approximately one quarter of the world's population, most commonly in Africa, Asia, and Latin America, are believed to be infected with tuberculosis. Though latent tuberculosis is not contagious, it can become active at a later time, leading to both negative health outcomes for the infected and to the spread of the disease. Active tuberculosis is contagious and marked by symptoms including prolonged coughing with or without blood, fever, night sweats, chills, fatigue, and unintentional weight loss. Populations with HIV are more likely to become infected with tuberculosis due to the suppression of their immune systems, and are also more likely to have latent tuberculosis progress to active tuberculosis. Tuberculosis results in over a million annual fatalities, with the majority of deaths occurring in developing countries.
Effective testing for tuberculosis allows for early treatment and potential prevention of disease spreading. Those diagnosed with latent tuberculosis infections may elect to take medications to reduce the risk of tuberculosis becoming active. Diagnosis of active tuberculosis may result in actions to prevent the spread of tuberculosis, such as covering the mouth when coughing, wearing a mask, and reducing contact with others while undergoing treatment, which generally involves the administration of antibiotics.
Common detection methods include the tuberculin skin test, nucleic acid amplification tests, culture methods, and conventional microscopy. These methods, however, are often time consuming (taking from hours to months), require expensive laboratory equipment, and must be conducted by a trained clinical technician. Additionally, the tuberculin skin test may result in false positives for those who have previously received a Bacille Calmette-Guerin vaccine to reduce the risk of severe tuberculosis. A point of care test for the presence of Mycobacterium tuberculosis should therefore be relatively inexpensive to manufacture, provide rapid and reliable results, and operate without requiring experienced clinical personnel, additional equipment, or instruments.
The present disclosure generally pertains to methods and systems for detecting target species of mycobacteria using lectin-conjugated particles. For example, lectin-conjugated nanoparticles and lectin-conjugated silica coated magnetic nanoparticles (SMNPs) are presented for the rapid detection of Mycobacterium tuberculosis and subsequent diagnosis and treatment of tuberculosis. In some embodiments, a system detects Mycobacterium smegmatis, a mimic of Mycobacterium tuberculosis that is often utilized in the study of tuberculosis due to its faster doubling time and lower biosafety level facility requirements. In addition to sharing many homologous genes, Mycobacterium smegmatis has the same cell wall structure as Mycobacterium tuberculosis, which is not conducive to Gram staining. Lectin-conjugated SMNPs can be used to bind carbohydrate epitopes in the cell wall of the target species of mycobacteria. Mycobacteria-bound particles precipitate in samples containing the target species of mycobacteria, such that magnetically separated precipitate indicates the presence of the mycobacteria. The disclosed methods may be conducted in less than five minutes and, when used with samples containing Mycobacterium tuberculosis, may result in the diagnosis of tuberculosis and the offer of subsequent treatments.
The disclosure can be better understood with reference to the following drawings. The elements of the drawings are not necessarily to scale relative to each other, emphasis instead being placed upon clearly illustrating the principles of the disclosure. Furthermore, like reference numerals designate corresponding parts throughout the several views.
The present disclosure is generally directed to methods and systems for the rapid detection of mycobacteria in samples using lectin-conjugated particles. More particularly, the methods and systems of the present disclosure may be used for the diagnosis and treatment of tuberculosis through the detection of Mycobacterium tuberculosis in sputum samples. In this regard, glycolipids or carbohydrate epitopes within the cell wall of the mycobacteria, such as carbohydrate epitopes of lipoarabinomannan (LAM) in the instance where Mycobacterium tuberculosis is probed, serve as a binding site for lectins conjugated on the surface of lectin-conjugated silica coated magnetic nanoparticles (SMNPs). As the target species of mycobacteria bind to lectin-conjugated SMNPs, a precipitate forms, which can be magnetically separated from the bulk test solution to visually indicate the presence of the target species of mycobacteria. The present methods and systems are utilized as an inexpensive and rapid point of care system in the field in one embodiment. In another embodiment, the methods and systems are integrated into a lateral flow assay for rapid detection of the target species of mycobacteria. In yet another embodiment, the methods and systems are utilized to create a microfluidic detection device with increased sensitivity to mycobacteria in a sample. In some embodiments, lectins are conjugated to magnetic particles, while in other embodiments, lectins are conjugated to non-magnetic particles.
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A number of magnetic nanoparticles 5 are further stabilized and made biocompatible by incorporating a polymer matrix or producing a silica 6 coating. The number of magnetic particles 5 to incorporate per silica-coated particle may be varied as suitable for each application, as variation of the concentration of magnetic nanoparticles 5 affects the size of the resulting SMNPs 7. This silica 6 coating may be accomplished by any suitable method, including a method similar to the reverse micelle method of Selvan et al., (S T. Selvan, T. T. Tan and J. Y. Ying, Adv. Mater., 2005, 17, 1620-1625.), which is hereby incorporated by reference in its entirety. In an exemplary silica 6 coating method, magnetic nanoparticles 5 (0.5 mg) are dispersed in cyclohexane (22 mL) and a solution of APS in cyclohexane (60 μL, 0.1 mM) is added, followed by stirring the mixture at approximately room temperature for about 30 minutes. Next, IGEPAL (0.225 g) in cyclohexane (5 mL), NH4OH (25%, 100 μL) and TEOS (100 μL), are added sequentially and the mixture is stirred for about 30 minutes, about 1 hour, and overnight, respectively, after the addition of each reagent. The product is purified by centrifugation at 15000 rpm for about 10 minutes and by re-dispersion in ethanol about three times to produce SMNPs 7. Variation of concentrations of IGEPAL may be undertaken to alter the size of resulting SMNPs 7, as suitable per application.
The SMNPs 7 may also be functionalized with a linker molecule, such as NHS-PEG-silanes, so that they may react and become conjugated to lectin 8. NHS-PEG-silane may range from about 1 kDa to about 5 kDa, or may be of any molecular weight such that the linker effectively conjugates lectin 8 to SMNPs 7 and retains the function of lectin 8 after conjugation. The amount of NHS-PEG-silane to use during functionalization is calculated based on size of SMNPs 7 after silica 6 coating and concentration of SMNPs 7. For instance, 1 mg/mL SMNPs 7 may be mixed with NHS-PEG-silane and stirred overnight. The solution may be purified by centrifugation at 15000 rpm for about 10 minutes, followed by re-dispersion in ethanol. Additional linker molecules capable of binding both the SMNPs 7 and lectin 8 and providing effective spacing of conjugated lectin 8 from SMNPs 7, such that lectin 8 may bind target carbohydrates, are contemplated for use in the present disclosure. Resulting SMNPs 7 range in diameter from about 200 nm to about 700 nm. This size range is selected to produce lectin-conjugated SMNPs 9 of about 400 nm to about 800 nm in diameter after lectin 8 conjugation.
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In the instance where the species of mycobacteria 14 is Mycobacterium tuberculosis or Mycobacterium smegmatis, a glycolipid that has particularly unique abundance is lipoarabinomannan. Con A has a high affinity for the mannan residues and AAL has a high affinity for the arabinose residues, making both Con A and AAL suitable choices for binding specifically to Mycobacterium tuberculosis or Mycobacterium smegmatis. When detection, diagnosis, or treatment of tuberculosis is a goal, assays for the presence of Mycobacterium tuberculosis are useful. However, development of assays is often undertaken using Mycobacterium smegmatis as a model due to its high similarities in genetic makeup and cell wall structure with Mycobacterium tuberculosis and its lower biosafety level requirements for facilities and fast growth.
Lectin 8 conjugation may be undertaken by the following exemplary process: N-hydroxysuccinimide (NHS) groups present on surface of linker-functionalized SMNPs 7 are used to conjugate the SMNPs 7 with amine groups of lectins 8. The lectins 8 are mixed with linker-functionalized SMNPs 7 and stirred overnight. The amount of lectin 8 required to conjugate 1 mg/mL of SMNPs 7 is calculated based on size and concentration of SMNPs 7. The solution is then centrifuged at about 15000 rpm for about 10 minutes and re-dispersed in water, producing lectin-conjugated SMNPs 9. Lectin 8 conjugation to SMNPs 7 can be analyzed using techniques such as dynamic light scattering, zeta potential measurements, and FTIR. Resulting lectin-conjugated SMNPs 9 generally range between about 400 nm and about 800 nm. When lectin-conjugated SMNPs 9 are less than about 400 nm in diameter, precipitate 13 may not form or may form in low amounts such that visualization without use of specialized equipment is not possible. When lectin-conjugated SMNPs 9 are greater than about 800 nm in diameter, they may self-precipitate, rendering detection methods and devices ineffective. Another parameter to consider in conjugating lectin 8 to SMNPs 7 is the lectin density. In one instance, 50 μg lectin 8 is present on 1 mg SMNPs 7. Increasing lectin density may increase binding interactions with carbohydrate epitopes, but may also result in reduced function of lectins 8 at some high densities due to packing. Reducing lectin density may decrease the number of binding events or increase times for precipitate 13 formation.
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After precipitate 13 is either determined to be present or not present in working solution 11, the presence or absence of the target species of mycobacteria 14 is determined as well. When no or substantially no precipitate 13 is formed after incubation, the result is that the species of mycobacteria 14 is not present in sputum sample 10 of the human subject, and the human subject may not be diagnosed with or treated for any connected condition or disease. For instance, when precipitate 13 indicates the presence of Mycobacterium tuberculosis, the human subject who provided sputum sample 10 may be diagnosed with tuberculosis or treated for tuberculosis. In this instance, treating may include the reduction of tuberculosis transmission or spreading from the human subject or the reduction of symptoms in the human subject. When no precipitate 13 or substantially no precipitate 13 is visible, the absence of Mycobacterium tuberculosis in sputum sample 10 is indicated, leading to no diagnosis of tuberculosis or treatment based on results from the present methods and systems.
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Assay lines within test region 29 may comprise two lines: a test line 31 and a control line 32. In embodiments not depicted, lateral flow assay 25 may include multiple test lines to detect various molecules or compounds. In the embodiment depicted in
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Following mixing region 40, solutions enter separation region 42, where at least one magnet 15 is embedded in the device and configured to separate indicator particles 41 from unbound lectin-conjugated SMNPs 9 and unbound mycobacteria 14 or other solution components. In this regard, a magnetic field generated by at least one magnet 15 may apply a force (attract or repel) to the indicator particles due 41 thereby moving or separating them relative to the unbound lectin-conjugated SMNPs 9. In one embodiment, at least one magnet 15 separates indicator particles 41 using microfluidic magnetophoretic separations, which separate micro- or nano-scale magnetic particles within the microfluidic detection device 35. At least one magnet 15 may include situations where two or more magnets 15 are placed along a length of separation region 42, and magnets 15 may be of equal or unequal size, magnetic strength, or distance from separation region 42. As magnetic particles travel along separation region 42, they are initially attracted towards the first magnet 15. The movement of particles depends on parameters such as the strength and position of the magnets 15, the magnetic permeability of the particles, and the size of the particles. Thus, when particles have similar properties but different sizes, larger particles experience greater drag forces and reduced movement compared to smaller particles. Thus, larger particles may require more magnets 15 or higher magnetic strength to migrate the same distance as a smaller particle. In the present disclosure, indicator particles 41 are larger than unbound lectin-conjugated SMNPs 9, such that, while both will experience movement due to magnetic forces, the size difference between the particles will alter their movement and paths in separation region 42, resulting in separation of indicator particles 41. Non-magnetic particles and components of the solution will not be drawn into trajectories by the at least one magnet 15. Other magnetic or non-magnetic separation strategies may be implemented on microfluidic detection device 35, such that indicator particles 41 are separated from other solution components. When non-magnetic separation strategies are employed in microfluidic detection device 35, lectin-conjugated particles may be lectin-conjugated non-magnetic particles, including lectin-conjugated microparticles and lectin-conjugated nanoparticles.
Separated indicator particles 41 may then enter a detection region 43 comprising a built-in detector 44. This detector 44 may be a cell counting device, a digital counter, or any other detector capable of counting indicator particles 41 as they pass through detection region 43 and communicating the resulting number to an operator. When the resulting number of indicator particles 41 exceeds a predetermined threshold, the result indicates the presence of target species of mycobacteria 14 and any corresponding disease or condition. When the resulting number of indicator particles 41 is less than a predetermined threshold, the result indicates the lack or low concentration of target species of mycobacteria 14 and fails to indicate any corresponding disease or condition associated with its presence or high concentration. Predetermined thresholds may be determined empirically or may be obtained from published studies or materials. Solutions exit microfluidic detection device 35 through at least one outlet 45.
When Mycobacterium tuberculosis is present in sputum sample 10, indicator particles 41 are formed as Con A or AAL binds lipoarabinomannan in mixing region 40. Detection of the resulting indicator particles 41 at levels above a threshold indicate that the human subject who provided sputum sample 10 has tuberculosis and diagnosis of tuberculosis is indicated. Microfluidic detection device 35 may be more expensive to prepare and complicated to operate than other embodiments of the present methods and systems, but it also affords the highest sensitivity to low concentrations of Mycobacterium tuberculosis and other target species of mycobacteria 14. Thus, earlier detection of tuberculosis is facilitated by use of a device such as microfluidic detection device 35.
In some embodiments, lectins 8 may be conjugated to non-magnetic particles, including nanoparticles and microparticles, for use in the present methods and systems. Non-magnetic particles may include polymeric particles, liposomes, dendrimers, silica particles, carbon nanotubes and particles, DNA nanostructures, micelles, and any other non-magnetic nano- or micron-sized material capable of conjugation with multiple lectins 8. In these instances, lectins 8 are conjugated on the non-magnetic particles to form lectin-conjugated particles, such that lectins 8 provide multivalent interactions with their target glycolipid residues or carbohydrate epitopes. In non-magnetic systems, lectin-conjugated particles may form precipitates 13, agglomerates 33, or mycobacteria-particle complexes upon binding their target species of mycobacteria 14, and are thus separated from bulk unbound mycobacteria 14 and lectin-conjugated particles by their binding interactions. In some embodiments, further sorting of mycobacteria-nanoparticle complexes may be undertaken using size-based, affinity-based, or charge-based separation methods or any other suitable sorting or separation technique.
The foregoing is merely illustrative of the principles of this disclosure and various modifications may be made by those skilled in the art without departing from the scope of this disclosure. The above described embodiments are presented for purposes of illustration and not of limitation. The present disclosure also can take many forms other than those explicitly described herein. Accordingly, it is emphasized that this disclosure is not limited to the explicitly disclosed methods, systems, and apparatuses, but is intended to include variations to and modifications thereof, which are within the spirit of the following claims.
This application claims priority to U.S. Provisional Application No. 62/764,728, entitled “Rapid Diagnostics of Mycobacteria with Lectin Conjugated Magnetic Nanoparticles” and filed on Aug. 15, 2018, which is incorporated herein by reference.
Filing Document | Filing Date | Country | Kind |
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PCT/US2019/046719 | 8/15/2019 | WO | 00 |
Number | Date | Country | |
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62764728 | Aug 2018 | US |